A 58-year-old man with cirrhosis due to hepatitis B presents with a 2 cm nodule in the right lobe on ultrasound. MRI with hepatobiliary-specific contrast (gadoxetate disodium) is performed for HCC characterization. The structure marked **B** in the diagram is used as a key anatomical landmark to determine the extent of hepatic resection. Which of the following best describes the functional significance of the structure marked **B** in liver segmental anatomy?

Question

Accepted Answer

B. Divides the right lobe into anterior (segments V, VIII) and posterior (VI, VII) segments, independent of the middle hepatic vein. The right hepatic vein (marked **B**) is the critical anatomical landmark that divides the right lobe into anterior segments (V and VIII) and posterior segments (VI and VII). This division is functionally and surgically important and is independent of the middle hepatic vein's role. In modern hepatobiliary MRI with gadoxetate disodium (Eovist/Primovist), precise visualization of the right hepatic vein allows surgeons to plan segmental resections accurately for HCC in cirrhotic patients. The right hepatic vein's segmental distribution is essential for determining the extent of resection while preserving adequate liver remnant. This anatomical knowledge is critical for LI-RADS scoring and operative planning in HCC management (Bailey & Love 28e, Hepatic Segmental Anatomy section).

Answer

A. Drains segments I, IV, and V exclusively and is the primary venous drainage of the caudate lobe

Answer

C. Runs along the Cantlie line and separates the right lobe functionally from the left lobe

Answer

D. Defines the gross anatomic boundary between right and left lobes at the level of the falciform ligament

Explanation

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